I'm a little late, but briefly I would think that if the baby had been
nursing so ineffectively as to result in inadequate gain, then, no matter
that this mom had successfully breastfed several children before, the
inadequate emptying/drainage achieved by *this* baby over several weeks
would have caused a compromised breastmilk supply.  As well as doing
everything to assist baby to suck more effectively, it would be necessary to
manually express or pump to re-stimulate milk production.  Could it be that
mom finds pumping difficult because the supply is very low already?  Perhaps
you could treat this similar to a re-lactation scenario to start with?

And just BTW, palatal obturators have been provided for every single cleft
palate baby I have ever worked with, within *hours* of birth - they are
considered to be absolutely essential for oral development, and are replaced
as necessary as the baby grows.  However, I do not find that they assist
breastfeeding, being very thick and clumsy - so a mixed blessing.  Best
wishes to mom and baby, any breastmilk will be wonderful for the baby.

Pamela Morrison IBCLC, Zimbabwe
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Pamela Morrison IBCLC, Zimbabwe
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